Su Chien-Chia, Lee Yi-Chieh, Lee Peter Richmond Candano
Department of Ophthalmology, National Taiwan University Hospital College of Medicine, National Taiwan University, No. 7, Chung-Shan S. Rd, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Graefes Arch Clin Exp Ophthalmol. 2021 May;259(5):1243-1251. doi: 10.1007/s00417-020-05067-y. Epub 2021 Jan 12.
To prospectively evaluate the effect of benzalkonium chloride (BAK)-preserved latanoprost on ocular surface damage and identify the associated risk factors among treatment-naive glaucoma patients.
The basal Schirmer's test results, corneal Oxford staining score, non-invasive keratograph tear-breakup time, oculus hyperemia index score (objective metrics), and ocular surface disease index (OSDI) questionnaire (subjective metric) were evaluated at baseline, 1 month, and 4 months after receiving latanoprost eye drops. Associated risk factors were assessed by multivariate linear regression.
Seventy-four eyes (44 patients) were enrolled. Basal Schirmer's test tear-flow and Oxford scores gradually deteriorated (β = -0.14, P = 0.001 and β = 0.1, P < 0.001, respectively). The percentage of unstable tear-film (breakup time < 10 s) increased significantly at 4 months (6.21% vs 9.11%, P = 0.042). Hyperemic scores increased significantly at 1 month and normalized at 4 months (P = 0.01 and P = 0.16, respectively); total OSDI scores tended to improve (β = -0.76, P = 0.06). Older age was associated with additional corneal Oxford staining (P = 0.005); female sex was associated with increased unstable tear-film scores (P = 0.01). Artificial tear use was associated with a smaller decrease in basal Schirmer's test values (P = 0.01) and a smaller increase in unstable tear-film scores (P = 0.02).
Preserved latanoprost eye drops affected ocular surface changes in glaucoma patients through decreased basal tear secretion. Artificial tears represent an early intervention in vulnerable glaucoma patients with reduced tear secretion and impaired tear-film stability.
前瞻性评估苯扎氯铵（BAK）保存的拉坦前列素对初治青光眼患者眼表损伤的影响，并确定相关危险因素。
在接受拉坦前列素滴眼液治疗的基线、1个月和4个月时，评估基础泪液分泌试验结果、角膜牛津染色评分、非侵入性角膜地形图泪膜破裂时间、眼充血指数评分（客观指标）和眼表疾病指数（OSDI）问卷（主观指标）。通过多元线性回归评估相关危险因素。
纳入74只眼（44例患者）。基础泪液分泌试验的泪液流量和牛津评分逐渐恶化（β = -0.14，P = 0.001；β = 0.1，P < 0.001）。4个月时不稳定泪膜（破裂时间<10秒）的百分比显著增加（6.21%对9.11%，P = 0.042）。充血评分在1个月时显著增加，4个月时恢复正常（P = 0.01和P = 0.16）；总OSDI评分有改善趋势（β = -0.76，P = 0.06）。年龄较大与角膜牛津染色增加相关（P = 0.005）；女性与不稳定泪膜评分增加相关（P = 0.01）。使用人工泪液与基础泪液分泌试验值下降较小相关（P = 0.01），与不稳定泪膜评分增加较小相关（P = 0.02）。
保存的拉坦前列素滴眼液通过减少基础泪液分泌影响青光眼患者的眼表变化。人工泪液是对泪液分泌减少和泪膜稳定性受损的易患青光眼患者的早期干预措施。
